Evaluation of clinical frailty screening in geriatric acute care

被引:22
作者
Chua, Xin Ying [1 ]
Toh, Sabrina [2 ]
Wei, Kai [1 ]
Teo, Nigel [1 ]
Tang, Terence [2 ]
Wee, Shiou Liang [1 ,3 ]
机构
[1] Geriatr Educ & Res Inst, 2 Yishun Cent 2, Singapore 768024, Singapore
[2] Natl Healthcare Grp, Khoo Teck Puat Hosp, Singapore, Singapore
[3] Singapore Inst Technol, Hlth & Social Sci Cluster, Singapore, Singapore
关键词
clinical frailty scale; geriatric acute care; mortality; rehospitalization; CRITICALLY-ILL PATIENTS; ELDERLY-PATIENTS; TERM OUTCOMES; OLDER PERSONS; MORTALITY; ASSOCIATION; SCALE; MULTICENTER; MORBIDITY; ADMISSION;
D O I
10.1111/jep.13096
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: While frailty status is an attractive risk stratification tool, the evaluation of frailty in acute care can be challenging as some inpatients are unable to complete performance-based tests as part of frailty assessment and some toolsmay lack discriminative ability and categorize majority of cohorts as "frail". In this study, we evaluated the feasibility of frailty screening with the simple clinical frailty scale (CFS) by different clinicians, and its association with mortality and rehospitalization in a geriatric acute care setting. Methods: This study took place in Geriatric Medicine Department of a General Hospital in Singapore. We analysed records of 314 inpatients aged 70 years and older. At baseline, premorbid frailty was assessed using the CFS of the Canadian Study on Health and Aging. Demographic characteristics and other variables were retrieved from their medical records. Primary outcomes were mortality and rehospitalization during the 6-month follow-up. Survival analysis was used to compare the time to death and rehospitalization among CFS categories (1-4: nonfrail, 5-6: mild-moderate frail, and 7-8: severe frail). Results: CFS showed a high inter-rater reliability when used by different clinicians. In the Cox proportional hazard model controlling for age, gender, Charlson comorbidity index, modified severity of illness index, and discharge placements, severe frailty determined by CFS (HR = 2.09, 95% CI = 1.01-4.33, P = 0.047) and CFS scores (HR = 1.27, 95% CI = 1.05-1.53, P = 0.012) were significantly associated with higher mortality until 6-month postdischarge, but not rehospitalization. Conclusion: Frailty status determined by CFS adds to disease severity and comorbidity in predicting short-term mortality but not rehospitalization in older inpatients who received geriatric acute care in our setting. CFS is reliable and has the potential to be incorporated into routine screening to better identify, communicate, and address frailty in the acute settings.
引用
收藏
页码:35 / 41
页数:7
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